Results: QR rates for both studies remained stable ~1% each year (Table). However, Italy had a steadily increasing rate of QR. Hong Kong had a very high QR rate while Massachusetts (MA), Colorado (CO), New Jersey (NJ) & New York (NY) had higher than the US average (0.9% [SD0.6]) QR rates.

Globally, QRSP were from a wide range of sequence types (ST) & clonal complexes (CC). QRSP from Hong Kong were mainly ST81 (58/71), which was found in numerous locations worldwide. ST66 was the dominant clone in Italy (58/81), most collected from a single centre. There were 3 dominant CC in the US: CC81 (67/527), CC271 (37/527) & CC439 (34/527). QRSP were represented by >23 CC & were evenly distributed across the US except for CC81 which peaked in NY & CC439 which peaked in MA. QR was due to typical QRDR mutations as previously reported.

Conclusion: QR in Hong Kong was due to the dominance of CC81, as previously reported. QR in Italy was due to the emerging resistant clone ST66, although this could be a localized outbreak as most came from 1 centre in Catania over a short period of time. QRSP in the US was due to the presence of numerous clones including CC81 & CC439. The presence of CC271 in QRSP is also important as this clone is often associated with resistance to macrolides, penicillin, tetracycline & cotrimoxazole.

This study shows QR remained very low during both studies & was caused by multiple CC in most countries.

Table 1. Total number of isolates collected (N) & %QR by Year [NT; not tested]

Region

200001

0102

0203

0304

0405

0506

0607

Average

Hong Kong

N

70

58

74

70

62

73

93

71

%QR

14.3

15.5

10.8

11.4

17.7

17.9

12.9

14.2

Italy

N

119

284

267

285

228

192

590

281

%QR

0.0

0.7

1.5

3.9

4.4

5.2

7.5

4.1

MA

N

353

268

246

205

137

106

NT

219

%QR

4.8

1.9

1.2

2.4

2.2

0.0

NT

2.5

CO

N

65

239

265

108

226

167

NT

178

%QR

4.6

4.2

2.6

0.9

0.9

0.6

NT

2.2

NJ

N

191

193

160

35

81

NT

NT

132

%QR

1.0

3.1

1.9

2.9

0.0

NT

NT

1.8

NY

N

542

529

597

493

626

548

NT

556

%QR

1.7

1.1

3.0

1.6

1.4

1.3

NT

1.7

Global average

N

3435

4256

6320

6739

7083

6395

7465

5956

%QR

1.4

1.1

0.9

1.0

1.0

1.4

1.4

1.1

US Average

N

10,103

10,012

10,886

8494

9487

6747

NT

9288

%QR

0.9

1.2

0.8

1.1

0.9

0.8

NT

0.9

Session Details

Date:

10/04/2010

Time:

00:00-00:00

Session name:

Abstracts 20th European Congress of Clinical Microbiology and Infectious Diseases